Five compounds on this site are marketed for cognition, mood or stroke recovery. They sit at very different points on the evidence ladder, from a prescription drug registered with FDA Philippines and tested in thousands of patients, down to a peptide that has never been given to a human being in a published study. This page ranks all five by what their own trials actually showed.
| Compound | Best evidence | Stage |
|---|---|---|
| Cerebrolysin | Large RCTs and Cochrane reviews, over 1,700 patients pooled | Registered prescription medicine (FDA PH included) |
| Semax Stocked locally | Russian clinical study, 110 stroke patients | Approved medicine in Russia only |
| Selank Stocked locally | Russian active-comparator trials, about 60 patients each | Approved medicine in Russia only |
| Pinealon | Small uncontrolled human reports, one research group | Mostly cell and animal studies |
| Dihexa | None | Rat studies only |
Cerebrolysin: the only one with real RCTs, and the results are mixed
Cerebrolysin is not a single peptide but a mixture of small peptides and amino acids made by breaking down purified pig brain protein. It is a registered prescription drug in the Philippines, made by the Austrian company EVER Pharma, and it has been through more controlled human trials than the other four compounds on this page combined. That size cuts both ways. The largest trial, CASTA, randomised 1,070 stroke patients across Asia and found no significant benefit on its main outcome. A 2023 Cochrane review pooling seven trials and 1,773 patients found it probably makes little or no difference to death after stroke, and found more non-fatal serious adverse events on Cerebrolysin than on control. A separate Cochrane review of vascular dementia found a positive signal on cognition across six trials, but rated the evidence very low quality. In 2023 the Philippine DOH's Health Technology Assessment Council reviewed the stroke evidence, judged it low certainty, and recommended against government financing. Full detail: Cerebrolysin.
Semax: an approved Russian drug, with small and local human trials
Semax is a seven-amino-acid peptide built from a fragment of ACTH, sold in Russia as nasal drops for cognition and stroke recovery. Its best human evidence is a 2018 study that randomised 110 people recovering from ischaemic stroke to Semax plus standard rehabilitation or rehabilitation alone; those given Semax showed faster gains on a daily-living function scale in the first month. That trial compared Semax against no added treatment rather than a placebo, and it has not been repeated outside Russia. The proposed mechanism, raising brain-derived neurotrophic factor (BDNF), comes from a single rat study that measured BDNF in the hippocampus, not from any human brain measurement. Full detail: Semax.
Selank: same Russian network, aimed at anxiety rather than cognition
Selank shares Semax's Pro-Gly-Pro stabilising tail and its Russian research origin, but it is built on tuftsin, an immune peptide, and studied for anxiety rather than memory or stroke. Two Russian trials, each with about 60 to 62 patients, compared Selank against benzodiazepines, medazepam and phenazepam, rather than placebo, and reported a similar anti-anxiety effect without the sedation those drugs cause. It has been sold without a prescription in Russia since 2017. Whether calmer, less anxious thinking counts as "brain function" is a matter of framing, but the trial design and quality sit in roughly the same tier as Semax's. Full detail: Selank.
Pinealon: cell biology from one lab, human reports without the detail to judge them
Pinealon is a three-amino-acid peptide from the same St Petersburg research institute that produced epitalon. Its proposed mechanism, that short peptides enter the cell nucleus and directly change gene activity, is unusual even by peptide standards and has not been confirmed by an outside laboratory. The same institute's 2021 review cites a report of oral pinealon in 72 patients with after-effects of traumatic brain injury, with improved memory and fewer headaches, but the published material does not include the randomisation, blinding or side-effect detail needed to judge a modern trial. Full detail: Pinealon.
Dihexa: strong rat data, and literally no humans
Dihexa is a stabilised fragment of angiotensin IV designed to activate the HGF/c-Met growth-factor system in the brain. In rats it reversed drug-induced memory deficits and improved maze learning in old animals, and in cultured neurons it drove a large increase in new synapse formation. No human study of dihexa has ever been published. The closest related compound, fosgonimeton, developed from the same research programme by Athira Pharma, reached a phase 2/3 Alzheimer's trial in 312 people in 2024 and missed its main result; that does not test dihexa itself, but it is the only human-scale signal anywhere near this pathway. The same growth pathway that makes dihexa interesting, HGF/c-Met, is also a well-known driver in several cancers, a long-term risk that has not been studied. Full detail: Dihexa.
Why the ranking does not match popularity
Semax and Dihexa are two of the most discussed peptides in Manila's biohacker circles, and they sit at opposite ends of this list. Semax at least has a Russian regulatory approval and a randomised comparison in stroke patients; Dihexa has never been in a human study of any kind. Popularity and evidence quality are not the same thing anywhere on this site, and this category is where the gap is widest.
Status in the Philippines
Cerebrolysin is registered with FDA Philippines as a prescription medicine, though it sits outside the Philippine National Formulary, so government financing does not cover it; prescribing belongs with a licensed Philippine physician, usually a neurologist. Semax, Selank, Pinealon and Dihexa are not registered here as medicines and are not controlled substances; all four circulate through research-chemical suppliers rather than pharmacies.
